Smoking Men Research Articles

SMARCA4-deficient thoracic tumor detected by [18F]FDG PET/CT

BackgroundSMARCA4-deficient thoracic tumor (SMARCA4-DTT) is a distinct entity of undifferentiated thoracic malignancies newly introduced in 2015. Due to its unique clinical characteristic with aggressive thoracic tumor mostly observed in heavy smoker man with emphysema, with poor prognosis, many physicians are becoming increasingly aware of the disease; however, reports on 2-deoxy-2-[18F] fluoroglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) have been limited; thus, this disease is not yet widely known to nuclear medicine clinicians. As a first step in discussing the usefulness of [18F]FDG PET/CT for this disease, we present a case in which [18F]FDG PET/CT played a clinically important role.CaseA 74-year-old heavy smoker man with an anamnesis of severe emphysema characterized by pleural thickening and abnormal enhancement in CT underwent 18F-FDG PET/CT for further examination. [18F]FDG-avid pleural nodules infiltrating into the chest wall were detected and pathologically diagnosed as SMARCA4-DTT with biopsy.ConclusionSMARCA4-deficient thoracic tumor should be considered in a [18F]FDG-avid aggressive thoracic tumor in heavy smoker men with emphysema.

Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey

OBJECTIVESThis study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).METHODSThe subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.RESULTSThe prevalence of current cigarette smoking in men decreased by 2.8%p (APC=-2.8, p<0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC=-8.8, p<0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC=2.0, p<0.001), and the prevalence of binge drinking decreased in men (APC=-0.7, p<0.001) and increased in women (APC=2.4, p<0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p<0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC=-5.3, p<0.001), especially among women (APC=-6.4, p<0.001).CONCLUSIONSOver the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.

National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999-2016).

Approximately one in four deaths among people living with HIV (PLWH) in the United States can be attributed to cigarette smoking. Using a nationally representative sample of PLWH, this study examines the prevalence, time-trends, and correlates of current cigarette smoking among PLWH compared to people without HIV. Secondary analysis of population-based cross-sectional biobehavioral survey. Data were pooled from the 1999-2016 National Health and Nutrition Examination Survey (NHANES). All adults (20-59 years) who self-reported their smoking status and were tested for HIV (HIV+ = 152; HIV- = 26 305) were included in the analysis. Prevalence with 95% confidence interval (95% CI), trend analysis by year and group (HIV+/HIV-), and multivariable logistic regression analyses were performed with the complex survey design adjustments. Overall, 47.0% of PLWH were current smokers compared to 25.5% of those without HIV. From 1999 to 2016, the decline in smoking in PLWH was comparable to those without HIV (10.7% vs. 8.0%). PLWH smokers were more likely than PLWH nonsmokers to be substance users (adjusted odds ratio [aOR] = 17.52; 95% CI = 2.04 to 27.8). Compared to smokers without HIV, PLWH smokers were more likely to be older (1.10; 1.06 to 1.14), males (7.96; 2.50 to 25.40), non-Hispanic Black (10.45; 4.13 to 26.45), with depression (Patient Health Questionnaire-9 sum score ≥5) (3.79; 1.22 to 11.79), and less likely to be gay (0.02; 0.00 to 0.07). Cigarette smoking among PLWH is a major public health problem in the United States. Targeted and tailored smoking cessation interventions that incorporate assessment and treatment of depression and co-occurring substance use are critical for PLWH, especially among those who are disproportionately affected by smoking and HIV (sexual minority). This study offers important research implications in four areas:1. The decline in smoking among PLWH over 18 years has been modest, and half of PLWH are still smokers.2. More resources and efforts should be allocated to reduce cigarette smoking among PLWH.3. There is a critical need to develop and test culturally tailored smoking cessation interventions for minority subgroups who are most impacted by HIV infection and smoking (non-Hispanic Blacks and men who have sex with men)4. Smoking cessation interventions designed for PLWH should incorporate assessment and treatment of depression and substance use.

Smoking and stress in the general population in Denmark.

INTRODUCTIONThe social pressure placed on smokers today might potentially lead to an increasing level of stress. We investigated if the proportion of persons with high stress level had increased over time more in smokers than in non-smokers.METHODSData were obtained from repeated cross-sectional surveys of The Capital Region Health Survey conducted in 2010, 2013 and 2017. Survey data were weighted for survey design and non-response, and linked to national register data. Cohens Perceived Stress Scale (PSS-10) score was used. Logistic regression analyses, based on 136608 citizens’ self-reports, were adjusted for sex, age, education level, employment, and alcohol intake (and loneliness, in analysis investigating the associations between tobacco consumption and high stress level).RESULTSA significantly higher proportion of citizens reported a high stress level in 2017 compared with 2010 and 2013 but there was not a greater increase in smokers than in non-smokers. Daily smoking men had 69% higher odds of reporting perceived high stress level and daily smoking women had 36% higher odds, than never smokers of the same sex. There was a significant trend between higher daily tobacco consumption and a higher proportion of smokers with high stress level.CONCLUSIONSThe increase in high stress level over time occurred independently of smoking status. Daily smokers had the highest odds of perceived high stress level, and a higher daily tobacco consumption was associated with a higher proportion of smokers with high stress level. Smoking cessation programs should, to a higher degree, consider implementing stress-coping elements to prevent relapse.

Socioeconomic inequality in prevalence of cigarette and Water-pipe smoking among Iranian adults: A blinder- Oaxaca decomposition Analysis

Background: To assess the association between socioeconomic inequality and the prevalence of tobacco smoking among Iranian adults in 2010. Methods: Data from the fifth national STEPS survey (WHO STEPwise approach to NCD Surveillance) were analyzed. A Blinder-Oaxaca decomposition method was applied to assess the association between socioeconomic inequality and the prevalence of daily cigarette and water pipe (WP) smoking among Iranian men and women. Results: From 10,615 participants in the survey, 4,203 (39.5%) participants appeared to be in the first and fifth quintiles of socioeconomic status (SES). For men, the prevalence of daily cigarette smoking was higher among those with low SES (23.1%) than those with high SES (11.1%) (P&lt;0.001). The observed difference was mainly attributed to the educational level (8.6%). We found no significant difference in high compared to low SES women for cigarette smoking (P value= 0.881). Although there was no difference between high and low SES men for daily WP smoking, low SES women had a higher prevalence of WP smoking (4.4%) than high SES women (1.3%) (P value=0.027). Education level was the major factor (3.3%) to explain the corresponding difference. The difference in WP smoking in high and low SES men was not statistically significant (P value= 0.199). Conclusion: Cigarette smoking in men and WP smoking in women are associated with SES in Iran. Education was the main factor explaining the differences in the prevalence of cigarette and WP smoking in Iranian men and women. Results from this study must be considered as a pivotal basis for designing a tobacco control program at national and sub-national levels.

Determinants of tobacco use in Sudan: secondary analysis of STEPwise Survey 2016.

Tobacco is a leading cause of death and illness despite > 50 years of antitobacco efforts. To establish the determinants of current and former smoking and smokeless tobacco use in Sudan as measured by the STEPwise Survey 2016. A household-based cross-sectional World Health Organization STEPwise Survey was conducted among 7745 Sudanese citizens aged 18-69 years across 11 states in Sudan. A 4-stage stratified cluster sampling design was implemented. The generic STEPS Instrument (version 3.2) was used and questions were tailored to the Sudanese context. Among current male smokers, 63.7% were aged ≤ 35 years, 50.7% were illiterate or did not complete primary school, 84.5% were employed and 52.4% were in the lowest 2 quintiles of income. Among male smokeless tobacco users, 54.8% were aged ≤ 35 years, 48.4% were illiterate or did not complete primary school, 89.7% were employed and 52.2% were in the lowest 2 quintiles of income. Using multivariate logistic regression models, current smoking in men was associated with older age, informal education, unemployment and lower income. Smokeless tobacco use was associated with age 18-25 years, informal education, unemployment and lower income. Both forms of tobacco use were associated with poor socioeconomic status and unemployment. Smokeless tobacco use was associated with age 18-25 years as opposed to smoking tobacco use. These results can inform the target audience of the future tobacco control plans.

Determinants of educational inequalities in disability-free life expectancy between ages 35 and 80 in Europe.

Socioeconomic inequalities in disability-free life expectancy (DFLE) exist across all European countries, yet the driving determinants of these differences are not completely known. We calculated the impact on educational inequalities in DFLE of equalizing the distribution of eight risk factors for mortality and disability using register-based mortality data and survey data from 15 European countries for individuals between 35 and 80 years old. From the selected risk factors, the ones that contribute the most to the educational inequalities in DFLE are low income, high body-weight, smoking (for men), and manual occupation of the father. Potentially large reductions in inequalities can be achieved in Eastern European countries, where educational inequalities in DFLE are also the largest.

Effect of a Multifactorial Intervention on Fracture in Patients With Type 2 Diabetes: Subanalysis of the J-DOIT3 Study.

AimsTo evaluate the effects of an intensified multifactorial intervention and patient characteristics on the incidence of fractures comorbid with type 2 diabetes.MethodsFracture events were identified and analyzed among adverse events reported in the J-DOIT3 study, a multicenter, open-label, randomized, parallel-group trial that was conducted in Japan, in which patients with type 2 diabetes were randomly assigned to receive conventional therapy for glucose, blood pressure, and lipids (targets: HbA1c < 6.9%, blood pressure <130/80 mm Hg, LDL-cholesterol <120mg/dL) or intensive therapy (HbA1c < 6.2%, blood pressure <120/75 mm Hg, LDL-cholesterol <80mg/dL) (ClinicalTrials.gov registration no. NCT00300976).ResultsThe cumulative incidence of fractures did not differ between those receiving conventional therapy and those receiving intensive therapy (hazard ratio (HR) 1.15; 95% CI, 0.91-1.47; P = 0.241). Among the potential risk factors, only history of smoking at baseline was significantly associated with the incidence of fractures in men (HR 1.96; 95% CI, 1.04-3.07; P = 0.038). In contrast, the incidence of fractures in women was associated with the FRAX score [%/10 years] at baseline (HR 1.04; 95% CI, 1.02-1.07; P < 0.001) and administration of pioglitazone at 1 year after randomization (HR 1.59; 95% CI, 1.06-2.38; P = 0.025).ConclusionsIntensified multifactorial intervention may be implemented without increasing the fracture risk in patients with type 2 diabetes. The fracture risk is elevated in those with a history of smoking in men, whereas it is predicted by the FRAX score and is independently elevated with administration of pioglitazone in women.

Association of Cigarette Smoking and Serum Concentrations of Vitamins A and E in Men: A Case-Control Study

Background: Cigarette smoking is associated with changes in blood concentrations of some antioxidant vitamins. This study aimed to determine the association of cigarette smoking with serum concentrations of vitamins A and E in men. Methods: This was a case-control study, in which the participants were 80 male smokers and 84 male nonsmokers (age range: 20-60 years). Data on dietary intake, health status, smoking habits, anthropometric characteristics, and vitamin levels were compared between cases and controls. Results: Smokers had significantly lower concentrations of serum vitamin E (p = 0.001) and vitamin A (p = 0.013) compared with nonsmokers. However, serum vitamin E to cholesterol ratio was not significantly different between smokers and nonsmokers. Moreover, the highest circulating concentrations of vitamin E was observed in smokers who smoked ≤9 cigarettes per day (p &lt; 0.03), while and the lowest vitamin E was seen in men smoking ≥20 cigarettes per day. Conclusion: The results of this study identified that cigarette smoking is associated with lower levels of serum vitamin E and vitamin A, although it was not associated with vitamin E to cholesterol ratio.

RISK FACTORS OF EPILEPSY ATTACKS IN PATIENTS WITH CHRONIC BRAIN CIRCULATORY DISORDERS

The aim of the research was determination of risk factors for epilepsy on the background of cerebrovascular pathology by comparative assessment of the influence of individual etiological factors on the risk of this pathology developing.&#x0D; Methods. The research was based on the analysis of medical history of 76 patients with chronic cerebrovascular disorders, 38 of whom had epileptic seizures. Patients were examined according to the local treatment protocol for patients with cerebral circulatory disorders. The examination included collection of life history and disease, determination of the degree of hypertension, the presence of concomitant cardiac (cardiac arrhythmia, coronary heart disease) and endocrine (diabetes mellitus, obesity) pathology, analysis of neuroimaging data to determine the presence of microangiopathy. For this purpose, magnetic resonance imaging was performed in the T2 – VI mode, especially with sequential suppression of the cerebrospinal fluid signal. The Fazekas visual scale is used to quantify the severity of this phenomenon.&#x0D; Results. In most cases, the onset of epilepsy (76% of cases in men and 71% – in women) is observed in patients with chronic cerebrovascular disorders aged 40–60 years. Significantly more often the first epileptic seizure in both gender groups of patients developed at the age of 50–60 years. According to the results of comparing the frequency of smoking in men and women of the researched groups, it was found that this bad habit was significantly more common in patients with epileptic seizures. According to the results of research, smoking significantly (p&lt;0.05) increases the risk of epileptic seizures among men by 7.5 times, among women – by 7.6 times. Alcohol consumption increases the risk of epileptic seizures in men by 4.8 times (p&lt;0.05). Factors that contribute to the development of epileptic seizures in patients with chronic cerebrovascular disorders include traumatic brain injury and general anesthesia. It was found that the presence of a medical history of trauma significantly increases the risk of epilepsy by 7.6 times (among men – 14.7 times, among women – 7.8 times), and surgery with general anesthesia – 11.7 times (among men – 9.3 times, among women – 14.3 times). It was found that the presence of a patient with chronic cerebral circulatory disorders of type 2 diabetes increases (p&lt;0.05) the risk of epilepsy by 4.2 times and obesity – by 7.6 times. Atrioventricular block was significantly more frequently observed in patients with epilepsy and cerebrovascular pathology (F=0.019030; χ2=6.73) than in patients without epileptic seizures. The risk of epilepsy in the presence of atrioventricular block increases 5.4 times. In the patients with epilepsy Fazekas 1 was observed in 7 (18.4 ± 6.29%) patients against 10 (26.3 ± 7.14%) in the group of patients without epilepsy. Men of the researched groups do not differ in the frequency of the corresponding degree of leukoareosis. Significant differences in the incidence of the corresponding degree of leukoareosis between women were found. The Fazekas criterion demonstrated a steady regular effect in prognostic mathematical models for assessing the risk of epileptic seizures in patients with chronic cerebrovascular disorders, developed by discriminant analysis.&#x0D; Conclusions. Thus, the research revealed the risk factors for epileptic seizures in patients with chronic cerebral circulatory disorders. It has been proven that the presence of hereditary predisposition, bad habits, concomitant cardiac and endocrine pathology increase the risk of epilepsy in patients with cerebrovascular pathology.

Carotid Intima-media Thickness in the Algerian Population: Reference ranges and association with cardiovascular risk factors

Carotid intima-media thickness as measured with ultrasonography is an inexpensive and noninvasive predictor of cardiovascular events. The objectives of this study were to determine the population reference ranges of carotid intima-media thickness for individuals aged 35-84 years in Algerian cohort and to analyze the association of carotid intima-media thickness with cardiovascular risk factors (age, smoking, diabetes, pulse pressure, lipid profile, and body mass index). Population-based cross-sectional study conducted in military hospitals of Constantine and algiers (Algeria). We described the mean and maximal values of carotid intima-media thickness of the carotid artery and of its 3 segments (common carotid, carotid bulb and internal carotid). We assessed cardiovascular risk factors and analyzed their association with carotid intima-media thickness using adjusted linear regression models. A total of 1547 individuals (54% women) were included, with mean age 58 years. Men showed significantly higher mean common carotid intima-media thickness than did women (0.71 vs. 0.67 mm). The strongest predictors of this measure were age (coefficients for 10-year increase: 0.65 and 0.58 for women and men, respectively), smoking in men (coefficient: 0.26), high-density lipoprotein cholesterol in women (coefficient for 10 mg/dL, increase: - 0.08) and pulse pressure in both sexes (coefficients for 10 mmHg increase: 0.08 and 0.23 for women and men, respectively). The results were similar for the mean carotid intima-media thickness of all the segments. This population-based study presents the reference ranges for carotid intima-media thickness in the Algerian population. The main determinants of carotid intima-media thickness were age and pulse pressure in both sexes.

Correlation Analysis of Serum Magnesium Concentration and Lipids in Health Population and Type 2 Diabetes Patients

Background: Cardiovascular disease (CVD) is the lead cause of death around the world. Dyslipidemia is strongly associated with CVD. Magnesium (Mg) is an essential trace element involved in many vital biological process, such as glucose and lipid metabolism. Previous studies have showed that hypomagnesemia or Mg deficiency is associated with an increased risk of type 2 diabetes, metabolic syndrome, hypertension, and CVD. Objective: To explore the correlation between serum magnesium (Mg) concentration and dyslipidemia in health subjects and type 2 diabetes patients. Methods: 3430 health subjects were selected and divided into adult (aged 18~59) and elderly (≥60 years) groups according to age. In addition, 63 patients with type 2 diabetes were selected. Propensity score based on age, gender, body mass index (BMI) and smoking history was matched at a ratio of 1:2 between patients and health controls. Results: There was a significant correlation between elevated serum Mg concentration and dyslipidemia in health adults, but no significant correlation between the two in the health elderly. Multiple linear regression showed that serum total cholesterol (TC), BMI and smoking in men while fasting plasma glucose and serum LDL-C in women were independent risk factors for elevated serum Mg concentration. Whereas, no significant correlation was found between serum Mg concentration and lipid levels in T2DM patients. Conclusion: Serum Mg concentration is correlated with serum lipids to a certain extent, while age, gender and disease status may also exert certain confound effects. The causal relationship between serum Mg and dyslipidemia needs to be further studied.

Clinical Characteristics and Prognosis of Young Middle Eastern Adults with ST-Elevation Myocardial Infarction: One-Year Follow-Up.

Aims:Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI.Methods and Material:A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated.Results:Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036).Conclusions:Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.

Feasibility and Efficiency Study of a Population-Based Abdominal Aortic Aneurysm Screening Program in Men and Women in Spain

Based on current evidence, one-time screening for abdominal aortic aneurysm (AAA) in men using ultrasound evaluation reduces mortality related to AAA rupture and is considered cost-effective, although all-cause mortality reduction still remains in question. In Spain, there is no population screening program for AAA, so the aim of our study was to perform a pilot population screening program in our area to assess feasibility and efficiency of an AAA screening program for men and women. A population AAA screening pilot program was performed in a Barcelona area, including 400,000 inhabitants. According to inclusion criteria, 4,730 individuals aged 65 years at the moment of the trial were invited for screening (2,089 men and 2,641 women). Primary care doctors, trained in duplex ultrasound abdominal evaluations, performed an abdominal aortic measurement. Individuals with a previous diagnosis of AAA, limited life expectancy, or wrong contact data were excluded. Participation data, aortic diameters, AAA prevalence, and related cardiovascular risk factors were analyzed. The results were used in a cost-utility model to assess the efficiency of the screening program. Participation was 50.3% in men and 44% in women. Eleven patients were excluded because of previously diagnosed AAA. Five new asymptomatic AAA were detected in 65-year-old men (0.5% prevalence), all being active smokers. When considering patients excluded for previous AAA diagnosis, the prevalence in 65-year-old men reached 1.4%. Global AAA prevalence in smoking men reached 2.67%. No AAA was detected in women. Subaneurysmal aorta prevalence in men was 2.9% (n=29), and in women, it was 0.08% (n=2). A cost-utility analysis model on screening versus no screening retrieved 13,664€ per quality-adjusted life years at a 10-year horizon and 39,455€ per quality-adjusted life years at a 30-year horizon. AAA population-based screening by ultrasound evaluation in primary care is logistically feasible in our area. Despite that, AAA prevalence is lower than expected in men, and null in women. Cost-utility model results indicate that a local AAA screening program is only efficient in a 30years' time horizon. Such inefficient results for a population screening make it necessary to consider other strategies such as opportunistic or subgroup screening in our area.

Acceptance of Love and Remarriage Among Older Adults in the Philippines.

Objectives: Later-life re-partnership has been linked to healthy aging, but little is known about Philippine older adults' perception of love and remarriage in older age. Methods: Using two nationally representative surveys on aging in the Philippines, we estimated the proportion of older adults reporting acceptance. Using weighted logistic regression, we assessed sociodemographic and health factors associated with acceptance as well as the relationship of this acceptance with social activity and health behaviors. Results: Only seventeen percent of respondents reported acceptance. Per multivariable analyses, unmarried men and married women reported acceptance, and acceptance was associated with increased social activity and smoking in men, less smoking in women, and more drinking in both genders. Discussion: Most older adults in the Philippines reported love and remarriage in old age as unacceptable. Through these results, we can understand how attitudes toward later-life relationship impact older adults' health and well-being.

Diferencias por edad y sexo en el control y tratamiento de la diabetes mellitus tipo 2 en un centro de salud

Objective. To know the degree of control and treatment of patients with type 2 diabetes (DM2) in our health area, differentiated according to age (< 65 and ≥ 65 years) and gender (male and female). Material and method. Observational, descriptive and cross-sectional study on the medical records of patients with DM2 from the Manzanares II Health Zone. Sociodemographic data, cardiovascular risk factors, vascular repercussions, laboratory values (glucose, lipid) and blood pressure, and drugs for the treatment of diabetes, dyslipidemia, arterial hypertension and with antiplatelet / anticoagulant effect are collected. Results. Data from 342 patients (men: 170; women; 172; 60% with ≤ 7% (no differences between groups) with 40% in the range of ≤ 6.5%. Total cholesterol ≤ 200 mg / dl in 75% of patients: higher percentage in ≥ 65 years and in men (p < 0.01 between age groups and p < 0.05 by gender) with LDL-cholesterol ≤ 100 mg / dl in more than half of the patients: better in ≥ 65 years and in men (with p < 0.01 between age groups and gender). The combination of controlled factors for HbA1C and LDL-cholesterol improved in those ≥ 65 years (p < 0.01). Higher prevalence of CKD in women and in those ≥ 65 years (p < 0.001 for age and p < 0.05 for gender). Higher prevalence of smoking in men and in < 65 years (p < 0.001, in both). ARA II and diuretics are more used in ≥ 65 years (p < 0.05 and p < 0.001) than in < 65 years. There are no differences in antidiabetic treatment by sex, but there are in terms of metformin and iSGLT2 (more frequent in < 65 years, p < 0.01). There are differences in the use of statins (p < 0.01) and fibrates (p < 0.05), higher (64.4%) in ≥ 65 years. There is greater use of anticoagulation (14.9% vs 5.8%, p < 0.05) in ≥ 65 years Conclusions. There are no differences in glucose control, but there are differences in lipid control and in the use of some hypoglycemic, statin and antihypertensive drugs.

Cognitive function in women with major mental illnesses who use tobacco

Cognitive effects of tobacco use among women with schizophrenia, bipolar disorder or depression have not been studied extensively as most studies focussed on men smokers. As part of a study on prevalence and cognitive effects of tobacco use, women with schizophrenia, bipolar disorder and depression were assessed for cognitive functioning using an information questionnaire derived from the Indian Post Graduate Institute Battery of Brain Dysfunction (PGIBBD) and the Trail Making Tests (TMT) A and B. The community dwelling women were clinically diagnosed and recruited from the outpatient department of a free tertiary care teaching hospital in India. The sample consisted of 321 women, 141 with schizophrenia (SZ), 80 with Bipolar Disorder (BD) and 100 with Recurrent Depressive Disorder (RDD). Tobacco users answered statistically significantly fewer questions on the PGIBBD Information Questionnaire. Users also took significantly more time to complete both TMT-A and TMT-B. Age, years of schooling and tobacco use were all significant co-variates for performance on cognitive tests. Tobacco users had lower motor speed and lesser visual scanning, poorer flexibility of thinking and working memory. Women with schizophrenia performed the worst. Tobacco use may exacerbate the cognitive dysfunction associated with major mental illnesses among women.

Gender Patterns in Immigrants' Health Profiles in France: Tobacco, Alcohol, Obesity and Self-Reported Health.

Background: to date, little attention has been given to gender differences in the health of migrants relative to native-born. In this study, we examine the health profile of the largest immigrant groups in metropolitan France, considering several health indicators and with a special interest in the gendered patterns. Methods: The data originate from the 2017 Health Barometer survey representative of metropolitan France. A subsample of 19,857 individuals aged 18–70 years was analysed using modified Poisson regression, and risk ratio estimates (RR) were provided for the different migrant groups regarding alcohol use, current smoking, obesity and less-than-good self-reported health, adjusting for age and educational level. Results: None of the groups of male migrants differs from the native-born in terms of self-reported health, and they have healthier behaviours for alcohol (men from sub-Saharan Africa: 0.42 (0.29–0.61)) and from the Maghreb: 0.30 (0.1–0.54)) and smoking (men from sub-Saharan Africa: 0.64 (0.4–0.84)), with less frequent obesity (men from the Maghreb: 0.61 (0.3–0.95)). The latter, however, more frequently report current smoking (1.21 (1.0–1.46)). For women, less-than-good health is more frequently reported by the groups from sub-Saharan Africa (1.42 (1.1–1.75)) and from the Maghreb (1.55 (1.3–1.84)). Healthier behaviours were found for alcohol (women from overseas départements: 0.38 (0.1–0.85)) and from the Maghreb: (0.18 (0.0–0.57)) and current smoking (women from southern Europe: 0.68 (0.4–0.97), from sub-Saharan Africa: 0.23 (0.1–0.38) and from the Maghreb: 0.42 (0.2–0.61)). Conversely, some were more frequently obese (women from overseas départements: 1.79 (1.2–2.56) and from sub-Saharan Africa: 1.67 (1.2–2.23)). In the latter two groups from Africa, there is a larger relative male excess for tobacco than in the native-born (male-to-female ratios of respectively 2.87 (1.6–5.09) and 3.1 (2.0–4.65) vs 1.13 (1.0–1.20)) and there is a female excess for obesity (0.51 (0.2–0.89) and 0.41 (0.2–0.67)) in contrast with the native-born (1.07 (0.9–1.16)). The female disadvantage in terms of less-than-good self-reported health is more pronounced among migrants from the Maghreb than among the natives (0.56(0.4–0.46) vs. 0.86 (0.8–0.91)). Conclusion: Considering a set of four health indicators, we provide evidence for distinctive gender patterns among immigrants in France. Male immigrants have a healthy behavioural profile in comparison with the natives and no health disadvantage. Female immigrants have a more mixed profile, with a health disadvantage for the non-Western groups from Africa. The contribution to this discordance of socioeconomic factors and gender relations needs to be investigated.

Spindle Cell Squamous Cell Carcinoma of The Larynx: A Report of Three Cases

Spindle cell squamous cell carcinoma (SCSCC) is a rare malignant tumor, which involves both squamous cell carcinoma and sarcomatoid proliferation. It remains uncommon in the larynx and represents only 1 % of SCSCC of the head and neck. This tumor still poses diagnostic and therapeutic challenges. In the present report, three cases of laryngeal SCSCC were investigated; their clinical, pathological findings, treatment and outcomes are described. The patients were smoker men aged 50, 66 and 66 years old respectively. Dysphonia was the mean symptom. The tumor involves the vocal cord in all cases. The patient underwent laryngectomy with bilateral neck dissection. Histological examination confirmed the diagnostic of SCSCC. One case showed basaloid squamous cell carcinoma with sarcomatous transformation and osteosarcoma. Immunohistochemical analysis performed in one patient was positive for vimentin, SMA, PS100, focally for EMA and negative for keratin and P63.One case presented lymph nodes metastases and an adjuvant radiotherapy was preconised for this patient. All patients were well controlled after treatment and there was no recurrence during the following up.

Socioeconomic characteristics of patients with coronary heart disease in relation to their cardiovascular risk profile

ObjectivePeople’s socioeconomic status (SES) has a major impact on the risk of atherosclerotic cardiovascular disease (ASCVD) in primary prevention. In patients with existing ASCVD these associations are less documented. Here,...